鼻出血是鼻腔疾病的常见症状之一,出血原因很多,一般出血部位在鼻中隔前下方的易出血区。而40岁以上中老年人的鼻出血,则多见于鼻腔后部,一般由鼻后侧静脉曲张及下鼻甲后方的鼻—鼻咽静脉丛导致鼻后部出血,同时也与老年人高血压有关。
随着年龄的增加,高血压的发病率不断增高,以高血压为病因的鼻出血发生率也明显增加。国内学者报道,由高血压引起的鼻出血占10%~25%。患者易受精神或环境变化的影响,鼻出血多发生在清晨或活动后。由于出血部位在后鼻道,加上血压较高、血管弹性差,故出血较猛。当患者看到出血较多时,又会造成心情紧张而使血压更加升高,导致出血不止。因此,老年人遇鼻出血,千万要保持镇静,放松心情,并将流入口中的血液尽量吐出,以免咽下刺激胃部引起呕吐,如果出血不止应马上到医院进行治疗。
值得警惕的是,反复鼻出血往往是脑出血的先兆。因为老年人鼻腔内血管硬化,血管壁纤维组织增生,弹性降低,脆性增加。当血压升高而脑血管未破裂之前,鼻腔的小血管会先破裂而发生鼻出血。因此,有高血压、动脉硬化的老人应提高警惕。
目前治疗鼻出血的方法主要有鼻腔填塞、微波、激光等疗法。术后应在医生的帮助下服用降压药及止血药,但也不要将血压降得太快。因为许多血压高的老人,机体的重要器官对高血压状态已经相对适应,如果血压降得太快,可使血流量锐减,影响心脑的血供而发生危险。老年鼻出血患者饮食应清淡易消化,要有充足的睡眠时间,保恃心情愉快,起卧、大便时动作应缓慢,以防血压升高再致鼻出血。
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